Can my Diastasis Recti be fixed?
This is a question my postpartum Moms ask me all the time.
We hear on social media that Moms need to work on closing the “gap” or the separation along the Diastasis Recti after having a baby.
I have even heard the expression “check yourself before you wreck yourself.” Not cool.
Some may even claim to prevent a Diastasis Recti while pregnant if you do their program or certain exercises. I call BS.
So what exactly is a Diastasis Recti? This is when the facia or tissues between the Rectus Abdominus muscles, also known as the “6 pack muscles,” become stretched and thinned out, causing a separation or a space along the middle of our abdominal region while pregnant.
The reality is that our abdominal muscles have to stretch to accommodate the growing baby. Research has shown that almost 100% of pregnant Moms will develop a Diastasis Recti by the end of their pregnancy.
Having a gap of more than 2 fingers width distance has been the standard test most professionals use as a test of having a significant diastasis recti. This measurement is taken with the index and middle finger placed side by side on top of the belly button while the Mom raises her head off the bed. If the distance width between the edges of the Rectus Abdominus is greater than the 2 fingers, this is considered to be a Diastasis Recti.
Is having a Diastasis Recti dangerous?
Unfortunately there is a lot of fear mongering on social media that can make Moms scared to exercise. In most cases unless there are medical precautions, Moms should be able and encouraged to continue exercising throughout their pregnancy with modifications.
However there should be some caution when women become pregnant and into the immediate postpartum period when the abdominal muscles have become stretched and weakened.
Moms can potentially become more susceptible to developing hernias along the abdominal muscles. Hernias can happen during pregnancy or with activities such as lifting heavy weights at the gym or maybe straining with work duties.
While a Diastasis Recti is a stretching of the facia, a hernia is when an abdominal organ or fat actually protrudes through the abdominal facia through an opening.
If there is an area along the abdominals that remained weak in the Postpartum period, this area can become susceptible to strain overtime.
Understanding what changes will occur along the abdominals should help guide our exercise choices during pregnancy and into the postpartum recovery phase.
While Moms can’t prevent Diastasis Recti while pregnant, they can choose and modify exercises as their belly grows to help minimize strain while still feeling challenged.
The good news is that Moms can also strengthen the core and pelvic floor during pregnancy, and then keep those connections along with modifications as their belly continues to grow into the third trimester.
With proper guidance there are no “good or bad exercises” such as weight lifting, but instead applying the modifications as needed to remain safe and make good decisions.
When will the Diastasis Recti or “gap” finally close?
Do Moms really care about the gap itself? Or do they care more about feeling good again wearing a swim suit, or maybe the ability to get back in their skinny jeans again?
Once again we have been conditioned through social media to think of the “gap” as something that needs to be “fixed.” However the gap is just one part of the whole abdominal wall. The entire abdominal wall of muscles have been stretched and weakened.
We have to load the abdominal muscles with challenging exercises to get the muscles stronger. In fact to truly strengthen along the muscles where the Diastasis is, we have to apply tension here which can actually make the gap “bigger.”
You may feel that when you do a sit up that the gap “closes”, however what is happening is that there is not enough tension to load the muscle. In fact the muscle may “sag” in the middle. Whereas when you activate a deeper muscle known as the Transverse abdominus along with a pelvic floor muscle contraction, this can help apply more tension along the “gap” and activate the muscles more effeciently.
Research findings imply that making the gap “bigger” as with a transverse abdominis contraction along with a pelvic floor contraction might improve the ability of the abdomen to accept more force. This is turn would promote more strength while we doing our day to day activities, such as lifting car seats, lifting strollers, etc.
Gone are the days where we just look at the 2 finger measurement horizontally as a measure of improvement. We also look at the firmness below the 2 fingers. Does it feel like we can sink our fingers down further into the belly, or does it feel like a “trampoline” with some firmness during exercise or activity.
In fact having a smaller gap doesn’t always mean that strength and function has been restored. You can have a flat stomach with a Diastasis, or have “doming” during exercise along the abdominal wall without a Diastasis.
We want to look more at the ability to perform exercises while maintaining some muscle integrity along the gap as well as the abdominal muscles in general. These include:
-Strength of core muscles involved
-Ability to perform the exercises without excessive “doming” or bulging along the gap and core
-Ability to do the exercise without pain, leaking, vaginal bulging
-Ability to do the exercise with the appropriate core strategy
-General fitness level
A larger “gap” doesn’t necessarily mean more impairment or deficits.
I had a patient recently that came in to see me because she wanted me to check her Diastasis Recti. She was a marathon runner and enjoyed doing Pilates. She had no complaints of back pain or any pelvic floor issues such as leaking or vaginal pressure. She did present with a 2 and half finger separation, but below my fingers the tissues were firm like a “trampoline.” I told her she was the perfect example of how having a “gap” does not define your abilities.
So it’s not the “gap” that matters, but more about the muscle integrity below the gap, along with the abdominal muscles working together during exercises to alleviate symptoms as needed.
The more we learn about Diastasis Recti, the less we see of the importance of just looking the gap itself in regards to performance and function.
That being said, the Moms that present with significant and obvious Diastasis do need more guidance. It can have an effect on their body image and self-esteem. This is why I am passionate about educating, guiding and empowering Moms to return to exercise with confidence both during Pregnancy and Postpartum.
Please call me at 317-689-0073 or email me at camille@indywomenpt.com I would love to help!
XOXO,
Dr. Camille Fenwick, Owner of Indy Women Physical Therapy
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